Becker's Clinical Quality & Infection Control

30 QUALITY IMPROVEMENT & MEASUREMENT Healthcare overuse is an equity issue, physicians group says By Andrew Cass I n a decade of aiming to reduce overuse in healthcare, a group of internal medicine physicians found that overuse is prevalent in racial and ethnic minority groups, leading to what it called a "possible double jeopardy." "(L)ong understood to be at risk of receiving less effective care, [minority groups] also appear often to be often at risk of receiving more ineffective care," members of the American Board of Internal Medicine Foundation wrote in a June 24 article in JAMA Health Forum. Choosing Wisely was formed in 2012 when the American Board of Internal Medicine Foundation parted with nine physician societies to announce 45 clinical recommendations that discouraged unnecessary care. The campaign now has 80 clinical partners and has issued more than 600 recommendations. Because high healthcare costs substantially impede access, patients with lower incomes from all racial and ethnic groups also are particularly vulnerable to financial harm from unnecessary care, the members said in the report. n Biden's plan to protect LGBTQ patients' healthcare: 5 things to know By Cailey Gleeson P resident Joe Biden signed an executive order June 15 to protect LGBTQ patients' healthcare, particularly for children. The executive order comes as more than 300 anti-LGBTQ laws have been introduced across the country this past year, including efforts by Florida and Texas governors to suspend gender-confirming care for children. Five things to know: 1. President Biden is charging HHS to release new sample policies for states on how to expand access to comprehensive healthcare for LGBTQ patients. 2. In order to begin efforts to ban conversion therapy — a widely discredited practice attempting to change a person's sexual orientation or gender identity — President Biden is instructing HHS to clarify that federally funded programs cannot offer the therapy and to begin work on a public information campaign about the practice. 3. The Federal Trade Commission is to consider whether conversion therapy constitutes an unfair or deceptive act or practice and whether to issue consumer warnings or notices. 4. HHS is to address the barriers and exclusionary policies LGBTQ individuals and families face in accessing healthcare, including mental healthcare, reproductive healthcare, and HIV prevention and treatment. 5. HHS is to expand youth access to suicide prevention resources and issue new guidance through the Substance Abuse and Mental Health Services Administration on providing evidence-informed mental healthcare for LGBTQ youth. n for a variety of initiatives, including creating the Hansjörg Wyss Wellness Center for refugees and immigrants. It's in the heart of the Southeast Asian refugee and immigrant community. During the pandemic, it saved and improved so many lives. Total fundraising is about $7 million on that project. We decided to do this because we have one of the top refugee health programs in the U.S., and people were getting their primary care in the emergency room. Some of our philanthropic initiatives are rooted in also helping the health system operate more efficiently. By opening the wellness center, we were able to reduce total cost of care and improve preventative medicine. But what's unique is everything we do, we spend so much time talking to the community. Asking the community and getting input is fundamental to what we're doing. Q: What advice do you have for other hospitals interested in health equity philanthropic efforts? ED: My advice would be to get the commitment from the board and the president. When you have commitment at the top of the organization, it serves as a cohesive force in mobilizing. We have 18 hospitals, a two-campus university and an insurance plan. e board and president being fully committed is a game-changer in fulfilling a spirit of philanthropy on health inequity within the whole organiza- tion. Plus, it speaks well to all our benefactors. Also, the Rippel Foundation, funded by the Robert Wood Johnson Foundation, put us through 18 months of training and the philo- sophical understanding of how to raise money and how to develop a program in fundraising for health equity. Having a partner like the Rippel Foundation, we had to commit one Friday a month to go through a symposium and we had reading materials. And I'm fully committed to this work, but it gave me the language, tools to use in developing our program. n

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